Intermenstrual bleeding / irregular vaginal bleeding

Borders Ref Help Toolkit
NHS Borders

Please note risk factors for endometrial neoplasia and hyperplasia are:

  • Age >45 years
  • Nulliparity
  • PCOS
  • Unopposed estrogen
  • Raised BMI
  • Diabetes
  • Hypertension
  • Tamoxifen use
  • Family history of breast/colon/endometrial cancer

Consider referral of these high-risk women early to secondary care for endometrial sampling

Intermenstrual bleeding flowchart

flowchart courtesy of NHS Lothian

Click for fullsized image

 

Irrregular vaginal bleeding flowchart

flowchart courtesy of NHS Lothian

Click for fullsized image

Who to refer, who not to refer, how to refer

Who to refer and who not refer:

Please refer to diagram above.

Please note risk factors for endometrial neoplasia and hyperplasia are:

  • Age >45 years
  • Nulliparity
  • PCOS
  • Unopposed estrogen
  • Raised BMI
  • Diabetes
  • Hypertension
  • Tamoxifen use
  • Family history of breast/colon/endometrial cancer

Consider referral of these high-risk women early to secondary care for endometrial sampling

How to refer:

Via SCI gateway as indicated in diagram above

Primary care management

Please refer to diagram above for primary care advice.

Local service details

Obsandgynae.mailbox@borders.scot.nhs.uk

Editorial Information

Author email(s): Obsandgynae.mailbox@borders.scot.nhs.uk.